Self-harm behavior in adolescents with mood disorders within the framework of schizophrenia spectrum disorders (pathopsychological and neurophysiological aspects)

Authors

O.V. Shushpanova

Mental Health Research Center, Russian Academy of Sciences, Moscow, Russian Federation

E.E. Balakireva

Mental Health Research Center, Russian Academy of Sciences, Moscow, Russian Federation

A.A. Koval-Zaitsev

Mental Health Research Center, Russian Academy of Sciences, Moscow, Russian Federation

L.P. Yakupova

Mental Health Research Center, Russian Academy of Sciences, Moscow, Russian Federation

S.G. Nikitina

Mental Health Research Center, Russian Academy of Sciences, Moscow, Russian Federation

T.E. Blinova

Mental Health Research Center, Russian Academy of Sciences, Moscow, Russian Federation

A.V. Kulikov

Mental Health Research Center, Russian Academy of Sciences, Moscow, Russian Federation

N.S. Shalina

Mental Health Research Center, Russian Academy of Sciences, Moscow, Russian Federation

https://doi.org/10.26617/1810-3111-2023-3(120)-55-62

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2023; 3 (120):  55-62.

Abstract

Background. Mental disorders in adolescents associated with non-specific self-injury with non-suicidal intent (hereinafter referred to as NSSI), known in the world as self-harm behavior (or as non-suicidal self-injury), are gaining particular significance in modern times psychiatry. The main goal of NSSI is to reduce the level of negative emotional stress and get rid of the “insensitivity” that accompanies dissociative disorders in adolescents. Objective: to study the role of mental disorders in the formation of self-harmful non-suicidal behavior, to determine clinical, pathopsychological and neurophysiological predictors of the formation of NSSI in adolescents aged 12-17 years. Material. The study was carried out based on the Department of Child Psychiatry of the Federal State Budgetary Institution “Mental Health Research Center”. The research sample included female adolescents aged 12-17 years (n=25), mean age was 14.15±0.95 years. Mental disorders were recorded within the framework of ICD-10 diagnoses: schizoaffective disorder, depressive type (F25.18), psychopathy-like schizophrenia (F21.4), undifferentiated schizophrenia (F20.3, follow-up less than a year). All patients were under conventional antipsychotic therapy during the study period. Methods: clinical-psychopathological, pathopsychological, neurophysiological (electroencephalography method), psychometric. The mental state of patients over time was assessed by clinical observation using the psychometric scales HDRS, HARS, PANSS and CGI. Results. Behavioral disorders accompanied by NNSI manifest themselves within the framework of schizophrenia spectrum disorders (F25.18, F21.4, F20.3), occurring with acute or subacute productive hallucinatory-delusional, psychopathy-like and negative symptoms, against a background of prolonged anxiety- a depressive state of moderate or high severity with a clearly defined antivital component that does not reach the level of active suicide attempts. In the majority (64%) of cases, an attack of an endogenous disease was accompanied by cognitive impairment of a deficient nature. The total quantitative score on the PANSS scale was 102.5 points, on the CGI scale ‒ 6-7 points, which corresponds to a pronounced and severe degree of psychopathological symptoms. Pathopsychological diagnostics of the characteristics of mental development revealed a special inharmonious type of cognitive development, specific thought disorders in the form of diversity, slipping, reliance on secondary signs, deficiency in the emotional-personal sphere, disorders of socialization and self-realization. The suppression and disorganization of the alpha rhythm and pronounced beta rhythm recorded from EEG data indicate the severity of the psychotic process; the predominance of slow-wave activity in the form of theta and delta rhythms is characterized by a clear connection with dissociated, delayed cognitive development, with a deficit state, with a decrease in the functional activity of the cerebral cortex.

Keywords: non-suicidal self-injury, emotional stress, dissociative disorders, schizophrenia spectrum disorders, clinical-psychopathological, pathopsychological and neurophysiological diagnostics.

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Materials  

For citation: Shushpanova O.V., Balakireva E.E., Koval-Zaitsev A.A., Yakupova L.P., Nikitina S.G., Blinova T.E., Kulikov A.V., Shalina N.S. Self-harm behavior in adolescents with mood disorders within the framework of schizophrenia spectrum disorders (pathopsychological and neurophysiological aspects). Siberian Herald of Psychiatry and Addiction Psychiatry.2023; 3 (120): 55-62. https://doi.org/10.26617/1810-3111-2023-3(120)-55-62.

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